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Washington, D.C., 12 November 2009 (PAHO) — The World Health Organization (WHO) has issued new healthcare guidance for the H1N1 influenza pandemic that encourages early treatment with antiviral drugs of ill people in high-risk categories and of anyone who has rapidly progressing symptoms.

The guidance reflects a more aggressive approach to the use of the main antiviral treatment, oseltamivir (Tamiflu). It is based on discussions with doctors from around the globe who have cared for severely ill H1N1 patients.

The updated recommendations emphasize three points:

  • People in high-risk groups—pregnant women, children under 2, and people with underlying conditions such as asthma and other respiratory diseases—should be treated with antivirals as soon as possible when they begin to have flu symptoms. Physicians should not wait for laboratory confirmation of H1N1.
  • People who are not in high-risk groups should be treated with antivirals if they have persistent or rapidly worsening symptoms. Danger signs include difficulty breathing or a high fever that lasts more than three days.
  • People who have already developed pneumonia should be given both antivirals and antibiotics, because many severe cases develop bacterial infections.


People with milder flu symptoms need not be treated with antivirals unless they are in high-risk groups.

In announcing the new guidance, Dr. Nikki Shindo of WHO’s Global Influenza Program, said many doctors involved in caring for very sick patients in intensive care units regretted that the patients had arrived too late for even the most sophisticated medical procedures to save their lives.

“When we asked what could have been done differently to avoid the tragic outcomes, all of them answered, without exception, that things may have been very different it they had been treated with an antiviral drug earlier,” said Shindo.

Most people infected with H1N1 recover without medication, Shindo emphasized, but the virus can cause severe pneumonia even in healthy young people and can claim a life within a week.

“The window of opportunity is very narrow to reverse the progression of the disease. The medicine needs to be administered before the virus destroys the lungs,” she said.

WHO is also encouraging countries to decentralize the distribution of antivirals so that general practitioners, not just hospitals, have access to these medicines for their patients.

“Patients should not need to visit a hospital in order to get antivirals prescribed,” said Shindo. “This should help ensure that individuals get the care they need faster, and that the burden on hospitals is reduced. This will leave hospitals freer to treat the most severe cases.”

Shindo said WHO is also recommending that countries with limited supplies of antivirals should prioritize their distribution, with an emphasis on early use for members of high-risk groups and in progressive and severe cases.
 
WHO and its regional offices, including the Pan American Health Organization (PAHO), have stockpiles of antivirals to help supply low-income countries. In addition, PAHO is pooling purchases of antivirals and vaccines for its member countries through the PAHO Revolving Fund.

PAHO was established in 1902 and is the world’s oldest public health organization. It works with all the countries of the Americas to improve the health and the quality of life of the people of the Americas and serves as the Regional Office for the Americas of the World Health Organization (WHO).


 

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Last Updated on Friday, 19 March 2010 09:24


2014

PAHO year in review: 2014 public health highlights in the Americas (12/24/2014)

years end-150The year 2014 was marked by progress as well as significant challenges for public health in the Americas. The region's countries advanced toward goals including universal health coverage, expanded access to vaccination, and ensuring that fewer babies are born with HIV. They also confronted major new challenges, including the arrival and spread of the chikungunya virus and the need to prepare for the possible imported cases of Ebola.

PAHO/WHO provides training in risk communication for possible Ebola introduction (12/09/2014)

Mesa directiva

Professionals from 11 countries of the Americas are in Quito, Ecuador, this week for a training workshop on risk communication organized by the Pan American Health Organization/World Health Organization (PAHO/WHO). The two-day workshop (December 9 and 10) is part of efforts to ensure that countries in Latin America and the Caribbean are prepared to respond effectively to potential imported cases of Ebola and other public health emergencies.

Avoiding local transmission of Ebola is the goal in Latin America and the Caribbean (11/10/2014)

Dr. Espinal, Director of the Department of Communicable Diseases and Health Analysis

The Director of the Department of Communicable Diseases and Health Analysis of the Pan American Health Organization/World Health Organization (PAHO/WHO), Dr. Marcos Espinal, said that preventing local transmission of Ebola is the main goal in preparing for the eventual arrival of cases of the disease in Latin America and the Caribbean.

Ebola: PAHO/WHO briefs health authorities on support for preparedness in the Americas (11/06/2014)

PAHO/WHO mobilizes Ebola preparedness teams in Latin America and the Caribbean (11/03/2014)

Countries of the Americas plan for possible Ebola introduction (10/31/2014)

PAHO Director Urges Countries of the Americas to Prepare for Early Identification of Possible Ebola Cases (10/27/2014)

Health officials briefed on Ebola and chikungunya during 53rd PAHO Directing Council (10/02/2014)

First imported Ebola case is reported in the Americas (10/01/2014)

PAHO Director briefs OAS envoys on Ebola in Africa and chikungunya in the Americas (09/25/2014)

WHO statement on the second meeting of the International Health Regulations Emergency Committee regarding the 2014 Ebola Outbreak in West Africa (09/22/2014)

WHO welcomes the extensive Ebola support from the United States of America (09/17/2014)

WHO welcomes Cuban doctors for Ebola response in West Africa (09/12/2014)

PAHO urges countries to eliminate mosquito breeding sites to prevent the spread of dengue and chikungunya (09/10/2014)

Statement on the WHO Consultation on potential Ebola therapies and vaccines (09/05/2014)

Ebola Virus Disease: Occupational Safety and Health (08/29/2014)

WHO issues "roadmap" to scale up international response to the Ebola outbreak in West Africa (08/28/2014)

PAHO Calls on the Countries of the Americas to Remain on Guard against the Ebola Virus despite a Climate of Calm (08/28/2014)

Unprecedented number of medical staff infected with Ebola (08/27/2014)

WHO-deployed health worker receiving care after testing positive for Ebola (08/26/2014)

Anecdotal evidence about experimental therapies (08/25/2014)

Why the Ebola outbreak has been underestimated (08/25/2014)

Travel and Transport in Relation to Ebola Virus Disease (EVD) Outbreak (08/18/2014)

Ethical considerations for use of unregistered interventions for Ebola virus disease (EVD) (08/11/2014)

PAHO/WHO urges the countries of the Americas to be vigilant and prepared for potential introduction of Ebola virus (08/10/2014)

“The Ebola epidemic is a serious public health problem, but it can still be controlled” (08/05/2014)

Número especial en periódico internacional sobre leptospirosis en la interface animal-humano-ecosistema (07/25/2014)

Dominican Republic is first country in the Americas to publish guidelines for clinical management of chikungunya (07/17/2014)

El Instituto Nacional para Síntesis Matemática y Biológica (NIMBioS) organizó taller para modelaje matemática de leptospirosis (06/10/2014)

Polio declared public health emergency of international concern under International Health Regulations (05/05/2014)

Countries of the Americas share risk of antibiotic resistance, must act now to protect health (04/29/2014)

Países de América debaten en Buenos Aires sobre la implementación del Reglamento Sanitario Internacional (04/29/2014)

Water and sanitation improvements remain key to defeating cholera in Haiti and the Dominican Republic (03/21/2014)

Haiti partners see progress, challenges in cholera control (02/05/2014)

2013

Representatives from the Ministries of Health met to discuss coordination and operational aspects of cholera prevention and control in the Subregion (12/09/2013)

Poster sobre leptospirosis gana premio en el Fórum de “Una Salud” en Davos, Suiza (11/22/2013)

Sesión sobre leptospirosis advoca por el enfoque de “Una Salud” para la reducción del impacto de los brotes (11/22/2013)

Simulacro de Leptospirosis en Choluteca, Honduras (10/31/2013)

Experts urge more WATSAN investments to halt cholera in Haiti, prevent its spread to more countries (10/25/2013)

USAID and World Vision join coalition to eliminate cholera from Haiti and the Dominican Republic (06/28/2013)

Experts in leptospirosis meet in Brasilia (04/15/2013)

2012

International Health Leaders Pledge to Work Together to Eliminate Cholera in Haiti and the Dominican Republic (10/16/2012)

2011

Llamado a la acción: La Hispaniola libre del cólera (12/28/2011)

Técnicos evaluaron respuesta y desafíos a un año de la epidemia de cólera en República Dominicana (12/07/2011)

Puerto Rico Presents Pilot Project for the Prevention and Control of Dengue (11/23/2011)

Journalism Award Winners Focus on Drug Resistance in Latin America (08/17/2011)

Haití condecora a la OPS/OMS por labor durante brote de cólera (04/20/2011)

Experts Warn of “Untreatable Infections” (04/05/2011)

Response to Cholera in Belle Fontaine, Haiti (01/28/2011)

Water, Sanitation and Hygiene Key to Control Cholera Epidemic in Haiti (01/10/2011)

2010

Experts to Discuss Cholera Vaccination in the Americas (12/15/2010)

Se prepara Plan de Contingencia ante la amenaza de un posible brote de Cólera en Guatemala (12/03/2010)

Cases Continue to Climb, But Fewer Patients are Dying from Cholera (12/02/2010)

National Day of Education and Prevention of Cholera in the Dominican Republic (12/01/2010)

Elections Not Expected to Increase Cholera Spread in Haiti (11/25/2010)

Cholera Outbreak in Haiti - Press Briefing by Dr. Jon Andrus, PAHO Deputy Director, 23 November 2010 (11/23/2010)

International Agencies Propose Joint Strategy to Fight Cholera in Haiti (11/16/2010)

PAHO Press Briefing on the Cholera Outbreak in Haiti, Tuesday, 16 November 2010 (11/15/2010)

PAHO Briefs NGO Partners on Cholera Outbreak in Haiti (11/15/2010)

Press Briefing on Cholera Outbreak in Haiti by Dr. Jon Andrus November 9 (11/09/2010)

Haiti’s Cholera Epidemic Likely to Grow Much Larger (11/09/2010)

Number of Cholera Cases and Deaths Still Rising in Haiti (11/02/2010)

CDC: Cholera Outbreak Strain Identified (11/01/2010)

PAHO’s Deputy Director Updates OAS’ Group of Friends of Haiti on Outbreak Situation (10/28/2010)

PAHO Position on Cholera Vaccination in Haiti (10/28/2010)

PAHO: Haiti’s Cholera Epidemic Still Trending Upward (10/27/2010)

PAHO: Haiti’s Cholera Epidemic Still Trending Upward (10/27/2010)

Press briefing on the cholera outbreak in Haiti by Dr. Jon Andrus, 27 October 2010 (10/27/2010)

PAHO: Cholera cases likely to increase in Haiti (10/25/2010)

PAHO Responds to Cholera Outbreak in Haiti (10/22/2010)

Taller analizó el impacto de la vacuna contra la influenza pandémica (09/15/2010)

WHO Declares H1N1 Pandemic Over, Urges Continued Influenza Vigilance (08/10/2010)

Facts and Myths about the Safety of the Pandemic Influenza (H1N1) 2009 Vaccine (05/26/2010)

Spain Donates Four Million Doses of Influenza A Vaccines to Latin American Countries (03/04/2010)

Nicaragua: Lista para recibir y aplicar la vacuna contra la Influenza AH1N1 en grupos priorizados (02/24/2010)

2009

Jóvenes de los Ecoclubes difunden mensajes de prevención frente a la pandemia de influenza H1N1 (12/14/2009)

WHO Says Prompt Treatment Can Prevent Serious Cases, Deaths from H1N1 (11/12/2009)

Preparing Communities to Respond to Pandemic Influenza (11/03/2009)

Autoridades de Salud alertan sobre brote severo de dengue en Nicaragua (10/02/2009)

PAHO Unveils Two Communities of Practice on Pandemic (H1N1) 2009 (09/21/2009)

Countries of the Americas Examine Response to Pandemic H1N1 2009 and Challenges Ahead (09/11/2009)

Países de las Américas se organizan para adquirir la vacuna de la gripe pandémica (09/10/2009)

Pandemic (H1N1) 2009 in the Americas: What's Next? (09/02/2009)

Chile's President Urges a Collective Response to A (H1N1) Pandemic (06/24/2009)

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